Review
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| If a TRICARE-eligible beneficiary has other health care coverage, such as employer group or private insurance, TRICARE considers this | other health insurance
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| Congress authorized the creation of the Emergency Maternal and Infant Care program (EMIC) during | WWII
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| TRICARE’s health maintenance organization (HMO)-type option is | Tricare Prime
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| The name of the total health care system of the U.S. uniformed services is called | Military Health System
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| TRICARE’s preferred provider organization (PPO) is | Tricare Extra
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| Military service personnel in the Army Reserves and National Guard are called | reserved components
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| The fee-for-service option that has basically the same benefits as original CHAMPUS is | Tricare Standard
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| A detailed and comprehensive questionnaire that establishes financial need is a | financial means test
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| A comprehensive health benefits program available to uniformed services retirees, their spouses, and survivors who are 65 or older is called | Tricare for Life
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| The time limit for filing a workers’ comp claim is established by | individual state statutes
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| The deadline for submitting TRICARE claims is within ____________________ of services rendered | 1 yr
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| What act provides workers’ compensation to employees of private maritime employers | Long Shore & Harbor workers comp
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| CHAMPVA eligibility can be lost in what situations | widow remarries, spouse divorce sponsor, dependant child turns 18
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| Health care professionals filing CHAMPVA claims should use the | CMS-1500
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| All CHAMPVA claims, whether electronic or paper, should be sent to the VA Health Administration Center in | Denver, Co
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| Examples of procedures/services for which preauthorization may be required for CHAMPVA beneficiaries include | routine dental care, hospice care, treatment for substance abuse
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| The three basic plans included in the TRICARE program are | Standard, Extra, Prime
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| The spouse or dependent child of a veteran who has been rated by a VA regional office as having a permanent and total service-connected condition or disability is eligible for | CHAMPVA
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| Active duty, retired or deceased service members are called | Sponsors
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| Eligibility can be confirmed by asking to see a Uniformed Services ID card or a family member’s Uniformed Services ID card or by calling | DEERS
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| Uniformed service members and their families who are on remote assignment 50 miles or more from a MTFRC and RCs and their family members called to active duty for 179 days or more may be eligible for | Tricare Prime Remote
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| A statement of certification from the MTF that says it cannot provide the specific health care the beneficiary needs is referred to as a | nonavailability statement
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| The two major classifications of disability coverage are | short term & long term
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| What classifications of businesses are not required to provide workers’ compensation for their employees | business who employ casual employees
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| Irresponsible on-the-job actions such as horseplay and/or use of illegal drugs can result in denial of | Workers Comp
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| The type of code that contains the full description of the procedure without additional explanation is the | stand alone code
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| How many levels of procedural coding are there | 3
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| What must accompany the claim when a rarely used, unusual, variable, or new service is performed | special report
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| How many levels of procedural coding are there | E & M
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| What symbol is used to show that the code has been changed or modified | triangle
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| Following the six sections listed in the main body of the CPT manual are the | category III codes
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| A main term can stand alone, or it can be followed up by three | modifying terms
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| In CPT coding, a patient who was seen on October 1, 2008, and then not seen again in the same medical practice until August 30, 2010, is classified as a | established Pt
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| Levels of service are based on three key components, including | Hx, examination, complex MDM
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| A patient’s medical record must contain sufficient documentation to support the use of | modifiers
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| The reason that the patient is seeing the physician, usually stated in his or her own words, is known as the | Chief Complaint
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| CPT codes can be displayed three different ways | single code, multiple codes,& range of codes
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| The time the health care provider spends in direct contact with a patient is called | face to face time
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| The AMA 5-digit codes used for reporting services performed by healthcare professionals are | Level 1 codes
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| The purpose of CPT coding.is | to provide a uniform language that accurately describe professional service performed
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| Symbol indicating an add-on code | +
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| Four factors can impact the E&M coding level reported. These are referred to as | contributing factors
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| Symbol identifying a change in wording of a new/revised code | >
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| Like history-taking, there are ____ degrees of patient examination | 4
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| Symbol used to indicate codes for vaccines pending FDA approval | Ϟ
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| Time is never a factor when a patient is seen in | Emergency department
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| How many diagnostic and treatment options were considered; | the amount and complexity of data reviewed; and the amount of risk for complications, morbidity, or mortality determine the complexity of decision making
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| Symbol identifying codes that include conscious sedation | ʘ
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| Symbol denoting modifier-exempt codes | Ø
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| Symbol representing a code that is new to the CPT book | •
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